In addition to the axillary lymph nodes, the internal mammary lymph nodes (IMLNs) drainage is another important lymphatic channel of the breast. The status of IMLNs also provides important prognostic information for breast cancer patients. The technical evolvements of sentinel lymph node biopsy (SLNB) and lymphoscintigraphy provided a less invasive method for assessing IMLNs than surgical dissection. Recently, many study concerning IMSLNB was performed in the patients with clinically negative axillary nodes. However, previous published studies concerning patients with breast cancer who all underwent a radical mastectomy have shown that IMLN metastases are mostly found concomitantly with axillary metastases. For this reason, IM-SLNB is even more important for clinically axillary node-negative patients. To our knowledge, this is the first attempt of the IM-SLNB in early breast cancer patients with clinically positive axillary nodes.

3~18 hours before surgery, under ultrasonographic guidance, 0.5~1.0 mCi 99mTc-SC in sterile saline (total volume 0.2~2.0 mL) is injected intraparenchymally into 2 quadrants of breast. Subsequently, LSG is performed 0.5~1.0 hour before surgery. IM-SLNB is performed during the surgery and the IMSLNs were sent to histologic examination

Procedure: IM-SLNB

IM-SLNB is performed according to the pre-operative lymphoscintigraphy

Other Name: Internal Mammary Sentinel Lymph Node Biopsy

Radiation: 99mTc-SC

Two syringes of 0.25~0.5 mCi 99mTc-SC in 0.2~1.0 mL volume were injected intraparenchymally into 2 quadrants of breast, at the 6 and 12 o'clock positions.

Other Name: 99mTc-labeled Sulfur Colloid

Device: Histologic Examination

All IMSLNs were analyzed by histologic examination for future therapy planning.

Other Name: hematoxylin-eosin staining and immunohistochemistry

Device: LSG

lymphoscintigraphy was performed 0.5~1.0 hour before surgery

Other Name: Lymphoscintigraphy

Detailed Description:

OBJECTIVES:

Determine the impact of routinely performed internal mammary sentinel lymph node biopsy on the systemic and locoregional treatments plan.

3~18 hours before surgery, under ultrasonographic guidance, 0.5~1.0 mCi 99mTc-labeled sulfur colloid in sterile saline (total volume 0.2~2.0 mL) is injected intraparenchymally into 2 quadrants of breast. Subsequently, lymphoscintigraphy is performed 0.5~1.0 hour before surgery. internal mammary sentinel lymph node biopsy is performed during the surgery and the internal mammary sentinel lymph nodes were sent to histologic examination.

Eligibility

Ages Eligible for Study:

18 Years to 70 Years

Genders Eligible for Study:

Female

Accepts Healthy Volunteers:

No

Criteria

Inclusion Criteria:

primary breast cancer

clinically axilla-positive

Exclusion Criteria:

enlarged internal mammary nodes by imaging

Contacts and Locations

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Please refer to this study by its ClinicalTrials.gov identifier: NCT01668914